First-Line Therapy for Ventricular Tachycardia After MI: What's the Best Approach?

Randomized trial results favor catheter ablation over antiarrhythmic drugs as first-line therapy for recurrent VT.

Patients with recurrent ventricular tachycardia (VT) from myocardial scar after a myocardial infarction (MI) have worse quality of life and outcomes than those without recurrent VT. Antiarrhythmic drug therapy and catheter ablation are common strategies for reducing VT episodes, but data comparing their efficacy as first-line treatment are lacking.

In the open-label VANISH2 trial (NCT02830360), investigators randomized 416 patients with ischemic cardiomyopathy, implantable cardioverter-defibrillators (ICDs), and VT to catheter ablation or antiarrhythmic drug therapy with sotalol or amiodarone. The primary endpoint was death or, after 14 days, appropriate ICD shock, VT storm (≥3 treated VT events within 24 hours), or sustained VT below ICD de…

Reviewing Author

Shea E. Hogan, MD, MSCS, FACC, FSCAI, FSVM

Disclosures

Editorial BoardsVascular Medicine

Shea E. Hogan, MD, MSCS, FACC, FSCAI, FSVM

Disclosures

Editorial BoardsVascular Medicine

First-Line Therapy for Ventricular Tachycardia After MI: What's the Best Approach?

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Reviewing Author